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IASP Curriculum Outline for Pain in Social Work

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Task Force Members

Outline Summary

Introduction Principles Objectives Curriculum Content Outline

Multidimensional Nature of Pain

Pain Assessment and Measurement

Management of Pain

Clinical Conditions

References

Introduction

The widespread prevalence of pain demonstrates the need for comprehensive pain education for all health-care professionals. Yet not all require the same type of pain-related knowledge and skills. IASP encourages all programs in social work to use the following curriculum outline to embed pain education and training. As with other health professions, an objective of curricula is to instill the knowledge and skills necessary to advance the science and management of pain as part of an interprofessional team. The desired outcomes of education emphasize critical competencies that support the humanistic aspects of health care and the learner’s capacity to carry out tasks successfully in the real world. The fundamental concepts and complexity of pain include how pain is observed and assessed, collaborative approaches to treatment options, and application of pain competencies across the lifespan in the context of various settings, populations, and care-team models.

The social work discipline has historically employed a biopsychosocial, strengths-based approach of assessing a person within the environment and honoring the subjective experience as the initial entre into the lives of those served. These values are a fundamental platform upon which social workers can build necessary skills to understand and influence the social, cultural, political, ethical, psychological, and spiritual aspects of pain.

Pain is both a societal and policy issue as well as an individual challenge for those experiencing it. Comprehensive pain assessment is individualized, patient and family-centered, multidimensional, and the focus of attention of clinicians, advocates, and political and regulatory institutions across the world.

Principles

Pain encompasses physical, emotional, cognitive, behavioral, spiritual, cultural, and interpersonal layers. Social workers who develop pain-specific knowledge are better able to assess and advocate for appropriate care and employ evidence-informed interventions that contribute to the team management of pain and related suffering. The multiple facets that converge around pain are relevant for social work intervention whether at the level of clinical care, research, policy, ethical analysis, advocacy, or education. With pain-specific knowledge, social workers are equipped to identify the need for referrals from pain specialists and to assess and intervene to reduce the negative impact that pain may have on an individual’s life.

Because pain is the most common reason a person seeks clinical care, and social workers are present in a variety of clinical settings, social workers are well positioned to identify patients’ unique needs when versed in pain’s presentation and impact. Untreated and undertreated pain represents a health problem demanding attention and advocacy, as the social work profession’s ethical commitment to social justice is challenged by a lack of access on the part of many individuals to comprehensive pain treatment and professional expertise; this reality is compounded among underserved and vulnerable populations.

A concurrent public health concern is the abuse of controlled substances, including opioids. This challenge requires expert assessment of the complex intersecting aspects of the pain experience as well as advocacy for access to multidimensional treatment modalities to balance the ethical obligation to manage pain properly with the safety of patients, the public, and prescribers.

Objectives

Social workers at the end of this entry-level pain curriculum will be able to:

Identify opportunities to function as advocates, care managers, clinicians, educators, and coordinators of treatment plans for persons living with pain, including preventing unrelieved pain and minimizing its social and behavioral consequences

Demonstrate a basic understanding of pain terminology and mechanisms

Integrate the relationship between types of pain and related emotional and functional challenges

Describe barriers to the reporting and management of pain and the consequences of unrelieved pain on individuals, families, and society

Demonstrate familiarity with screening and assessment tools and evidence-informed interventions

Discuss how the social work discipline’s historical commitment to vulnerable populations, social justice, and to the relief of suffering apply to the under-treatment of pain

Identify the myriad factors, including unique cultural factors, racial disparities, and substance misuse, that can contribute to a person’s pain experience, assess how these factors influence an individual’s and family’s response, and inform interventions

Demonstrate an understanding of the complex public health, political, and regulatory climate surrounding opioid medications, including the impact of medication diversion, global access, and prescribing practices for persons living with pain

Identify and address ethically challenging situations that undermine an individual’s ability to access adequate pain and symptom management and relief

Design, facilitate, and promote effective and culturally sensitive communication practices within institutions and among health-care providers and patients and their families

Recognize and influence the ethical discernment and decision-making processes that inform public policy and treatment of persons living with pain

Reluctance of patient (or support system) in recovery to accept opioids for fear of relapse

Fatalism

Untreated and undertreated pain

Vulnerable and marginalized populations such as women, children, older adults, poor and underprivileged, undocumented, minority racial and ethnic groups, individuals with substance use disorder, psychiatric illness, prisoners, persons with disability, nonverbal or speakers unfamiliar with the native language, and those who are terminally ill

Access to pain-specialized care

Financial and insurance barriers

Remote and rural areas

Lack of integrated health-care systems

Skills and strategies to enhance pain relief, self-efficacy, and outcomes